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Scattergood Ethics' blog

(CNN)The Centers for Medicare and Medicaid Services may now allow for states to pursue Medicaid reimbursements for short-term inpatient treatment in mental health facilities despite a decades-old exclusion, Health and Human Services Secretary Alex Azar announced Tuesday.
In a letter to state Medicaid directors, CMS detailed a new Medicaid waiver opportunity through which states may bypass...

“Nonvoluntary treatment,” would distinguish psychiatric patients who refuse help but likely would have accepted it in a healthy state of mind from the traditional “involuntary treatment”
August 24, 2017
PHILADELPHIA — The “involuntary treatment” of unwilling psychiatric patients has long been accepted as necessary in some cases, for the sake of patients and society, though it can raise...

Dominic Sisti & Cynthia Baum-Baicker
“The presidency is supposed to age the president, not the public.” And with that Jon Stewart, former host of the Daily Show and comic genius, touched on an overlooked but very serious public health question.
Is Donald Trump, with his daily Twitter harangues, impulsive and outrageous executive orders, and all around nastiness harming the health of...

By: Dominic A. Sisti, PhD, and Monica E. Calkins, PhD
Abstract
Schizophrenia and other psychosis spectrum disorders do not develop de novo but emerge from prodromal stages that are named and operationalized differently depending on the research group or consortium and its theoretical orientation. As a result, a complex lexicon now exists for characterizing individuals’ risk of subclinical...

There are hundreds of thousands of individuals in the US who have serious mental illness. Most of these individuals thrive in the community, but there remains a population who do not. Because the number of long-term psychiatric hospital beds has largely evaporated over the past 50 years, they often cycle between homelessness, acute care, and prison. Of the 2.5 million individuals incarcerated in...

By: Dominic A. Sisti, Ph.D., Chethan Ramamurthy, M.D.
View Author and Article Information at http://dx.doi.org/10.1176/appi.ps.201500400
Abstract
This column describes the gradual integration of psychiatrists into mainstream general medical care, from their exile as “alienists” in isolated asylums to their current roles in accountable care...

DOMINIC SISTI AND ANDREA SEGAL
The earliest psychiatric hospitals date back to 15th-century Spain, where they were conceived and constructed to give poor, homeless individuals with mental illness a safe place to live and, it was hoped, recover.
The next two centuries saw the degradation of asylums essentially into dungeons where mentally ill people were confined, living in chains and squalor...